Impact of a new acute oncology team (AOT) on quality of care and length of stay (LOS) of cancer patients admitted as an emergency to an acute (non-cancer) hospital


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Session type:

Helen Neville-Webbe1,2, Michelle Roberts1, Sarah Cox1
1Southport and Ormskirk District General Hospital, Merseyside, UK, 2Clatterbridge Cancer Centre, Merseyside, UK

Background

The National Chemotherapy Advisory Group (NCAG) 1 recommended all hospitals with an Emergency Department should have an AOT ensuring all cancer patients admitted as an emergency, are seen by oncologists. This discipline of ‘Acute Oncology' (AO) is subject to Cancer Peer Review. In our DGH the AOT consists of 2 consultant oncologists and 1 AO nurse, and secretary. We have analysed how an in-situ oncology team can improve the quality of care of AO patients, and reduce LOS.

Method

Prospective data is collected, including LOS, admission types and AOT clinical benefit.

Admission types are:

Type 1: New cancer including cancer presenting as metastatic disease and cancer of unknown primary

Type 2: Complications of cancer treatment (chemotherapy, radiotherapy)

Type 3: Complications of cancer itself

Clinical benefit is defined as

Major (managing new cancers, cancer treatment side-effects, preventing admissions); Intermediate (referrals to other teams, psychological support, patient information) or Minor (progress of patients, organising follow-up of patients).

Results

April 2012-April 2013 the AOT saw 787 AO patients. 4%, Type 1, 37% type 2 and 59% type 3. 96% of patients were seen within 24 hours, 4% seen within 48 hours. 76% patients seen received a major benefit, 18% an intermediate benefit and 6% a minor benefit. Pre-AOT average LOS was 12.1 days. With an AOT LOS is 8.7 days.

Conclusion

Having on-site oncologists in an acute hospital has improved the quality of care oncology patients receive and significantly reduces LOS.